hits vs non-hits

I am running squid in http_accel mode, and am noticing that although I have
reload_into_ims on, I'm still seeing things like TCP_REFRESH_MISS:DIRECT
7020 whenever I reload a page.

The page does contain a server side include which invokes a CGI program, but
it was my expectation that the results of this would be cached and not
refreshed except on the interval specified by refresh_pattern, since I have
reload_into_ims on.

Is there something I'm doing wrong, or something I need to do to get it to
cache these without going to the backing server every time?